Fluctuations in Pharmacokinetics Profiles of Monoclonal Antibodies

  • Tomasz GrabowskiEmail author
  • Joannes A. A. Reijers
  • Artur Burmańczuk
  • Anna Chełmońska-Soyta
Current Opinion


Monoclonal antibodies (mAbs) are a group of drugs with predicted slow linear and target-mediated distribution and elimination. Visual inspection of published pharmacokinetic profiles of mAbs frequently reveals plateaus in the distribution phase or an increasing concentration many days after a single intravenous dose. A question which has been left unanswered until now is whether mAbs undergo recirculation mechanisms. If so, then which mechanisms are crucial for the fluctuation in their pharmacokinetics profiles? What is the impact of such mechanisms on mAb absorption, distribution and elimination? Current commentary accounts for the fluctuation of mAbs concentrations based on different mechanisms, as well in different phases of their in vivo disposition. Current knowledge shows significant impact of mAbs lymphatic recirculation on characteristics of their pharmacokinetics profiles. Fluctuating or plateau phases in pharmacokinetic profiles of mAbs are a consequence of multiple simultaneously occurring recirculatory as well as adsorption/desorption processes rather than only slow, continuous elimination. Lymphatic recirculation as well as other mechanisms appears to be an obvious element of the mAbs disposition. Periodic changes in the key factors affecting mAbs disposition can be responsible for the unpredictable concentration peaks in absorption, distribution and the elimination phase.



Authors would like to express great appreciation to Neil Johnson Ph.D. for his professional guidance and valuable support in manuscript preparation.

Compliance with Ethical Standards


Tomasz Grabowski declare that his contribution in manuscript was related to financial support of The National Centre for Research and Development in Poland, Grant Number: POIR.01.02.00-00-0016/17.

Conflict of interest

The authors declare that they have no conflict of interest.


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Polpharma Biologics SA, Trzy lipy 3GdańskPoland
  2. 2.Centre for Human Drug ResearchLeidenThe Netherlands
  3. 3.Department of Pharmacology, Faculty of Veterinary MedicineUniversity of Life SciencesLublinPoland
  4. 4.Laboratory of Reproductive Immunology, Ludwik Hirszfeld Institute of Immunology and Experimental TherapyPolish Academy of SciencesWroclawPoland

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